Why is Trupanion so expensive?

I got pet insurance prices for my dog and I'm shocked with the cost Trupanion is quoting me. Trupanion was asking me for about $150, while all the other companies were closer to $50-$60 a month. Does Trupanion cover way more than other companies? From what I've seen, coverage isn't that different. I was leaning toward Trupanion because I liked the direct pay feature for vets, but I don't think I can justify paying three times as much for it!
 
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